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Category: Volume 08 Issue 09 September 2020
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Title: Functional Outcome of treatment of distal humerus fractures using distal humeral locking plates

Authors: Dr Tahir Shafi, Dr Imran Qayoom, Dr Mohammad Altaf Paul

 DOI: https://dx.doi.org/10.18535/jmscr/v8i9.24

Abstract

Objective: The treatment of multifragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable

joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal humerus fractures.

Methods: Thirty consecutive patients with articular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 11 cases of type C1, 4 cases of type C2 and 7 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score.

Results: Thirty patients were available for the final outcome analysis. There were 19 males and 11 females with an average age of 38.4 years (18-73 years). Clinical and radiological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks). The average follow-up was 12 months (10-18 months). Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 23 patients (76.6%). One patient had superficial infection.. There were no cases of primary malposition or secondary displacement, implant failure. There were two cases of ulnar neuropathy which recovered conservatively.

Conclusion: Anatomically preshaped distal humerus locking plate system is useful in providing stable fixation for complex distal articular fracture and facilitating early postoperative rehabilitation. The low rate of implant failure in the present study indicates that the technique is promising and warrants further investigation.

Keywords: Humerus; Fractures, bone; Bone plates; Fracture fixation, internal.

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Corresponding Author

Dr Imran Qayoom

Postgaduate Scholar, Department of Orthopaedics, GMC Srinagar, India